Nurse Burnout and Patient Safety

Subject: Nursing
Pages: 8
Words: 1261
Reading time:
5 min
Study level: Bachelor


There is a negative relationship between professional burnout and patient safety. According to the conducted reaches, once a nurse gets burnout, her patients’ safety level decreases (Garcia et al., 2019). Thus, there is a correlation between these two variables. Therefore, to increase patient safety, nurses’ burnout should be prevented. Scholars argue that high levels of burnout “is more common among physicians and nurses, and it is associated with external factors such as high workload, long journeys, and ineffective interpersonal relationships” (Garcia et al., 2019, p. 1). In other words, stress caused by overworking, extended business trips, and bullying among other workers may lead to nurses’ burnout and worsen patient safety accordingly. In this case, some interventions should be suggested to lower the stress level at work and improve team relationships.

There can be different levels of interventions helping to prevent professional burnout: either an individual or structural. Individual-focused interventions may include self-care workshops, stress management skills training, communication skills programs, yoga, massage, mindfulness, and meditation” (Zhang et al., 2020). As for the structural level, workload, stress management training programs provided by organizations, group face-to-face delivery, and teamwork can be addressed to prevent burnout and reduce stress (Zhang et al., 2020). In this proposal, the individual level will be emphasized. Firstly, individual blended learning of stress management skills at the relevant programs will be discussed. Then, the intervention concerning the change in behavior that helps in the fight against bullying and discrimination among nurses will be analyzed.

Blended Learning of Stress Management Skills

Evidence for The Proposed Intervention and Its Main Objective

To begin with, one of the proposed interventions concerns stress management skills, including mindfulness and resiliency, which nurses are recommended to improve with the help of the SMART program. According to Magtibay et al. (2017), “Mindfulness refers to the practice of learning to focus attention and awareness on the moment-by-moment experience with an attitude of curiosity, openness, and acceptance” (p. 392). Another crucial factor preventing nurses’ stress is resiliency, which “is the ability to overcome challenges and to bounce back stronger and wiser” (Magtibay et al., 2017, p. 392). Stress Management and Resiliency Training is a program that aims at enhancing peace, joy, resilience, and altruism, thereby reducing stress and improving well-being. Although SMART showed efficiency in increasing specialists’ mindfulness and resiliency during tests, the main objective for not all nurses using it is the problematic access (Magtibay et al., 2017). That is why scholars suggest that the program’s participants should choose the learning format (Web-based, independent reading, facilitated discussions), keeping in mind their learning styles and goals (Magtibay et al., 2017). Thus, blended learning of stress management skills is recommended for nurses to change the perception of different challenges at work.

Required Resources and Anticipated Outcomes of the Intervention

The intervention concerning learning stress management skills via SMART requires human and informational resources. Firstly, for nurses to participate in stress management training (either SMART or others), creators of the program need to understand that nursing is a profession that requires overworking. Thus, nurses do not have much time and energy to participate in such activities offline fully. For nursers, such resources (apart from time) as technology are needed: computers and access to the Internet. Moreover, distance mode of education, including video calls, should be considered the most preferred for nurses because they are most likely to prefer spending time at home. According to the research conducted by Magtibay et al. (2017), the blended learning mode of the stress management program “showed improvements in stress, anxiety, resilience, mindfulness, happiness, and burnout among nurses with a SMART program as early as week 8. The gains continued through week 24.” (p. 393). Thus, one should anticipate improvements in nurses’ emotional conditions in the eighth week of the blended learning training. For this, one can measure the outcomes with the help of questionaries and conducted interviews.

Evaluation of Intervention

This suggestion concerning the learning of stress management skills needs to be evaluated at least after the eighth week of the program. However, after preliminary analysis, training in a blended format will improve nurses’ mindfulness and resilience, preventing professional burnout and increasing patient safety with a high probability. In addition, the program requires less financial resources because of involved distance learning and independent readings, which increase the chances of its success.

Changing Behavior To Fight Bullying and Discrimination Among Nurses

Evidence for The Proposed Intervention and Its Main Objective

Another intervention that may help in preventing nursing burnout concerns reducing workplace bullying and discrimination. Johnson et al. (2019) claim that bullying and discrimination have negative relationships with patient safety perceptions through their influence on burnout. Moreover, it is necessary to state that Black, Asian, and minority ethnic (BAME) nurses and midwives “experience higher levels of discrimination than White nurses and midwives” (Johnson et al., 2019, p. 604). It seemed that bullying could not occur in nursing because workers there tend to protect others and make patients’ lives better. On the contrary, bullying and lateral violence are more likely to occur in stressful conditions and high workloads, which all relate to the nursing profession (Edmonson & Zelonka, 2019). However, it is complicated to cope with discrimination and lateral violence on one’s own because only top-down regulations can completely change the working atmosphere, which is a significant objective of the self-help intervention.

Required Resources, Anticipated Outcomes, and the Evaluation of the Intervention

The self-help intervention encourages nurses to act according to three strategies in cases of bullying. These ways to fight lateral violence are: preventing future bullying behavior, stopping incidents of bullying behavior, and promoting others to act (Smith et al., 2020). These strategies are based on the Social-Ecological Model, the individual level of which suggests intervention targeting individuals’ attitudes, beliefs, and behaviors (Smith et al., 2020). Therefore, to deal with personal beliefs and attitudes, emotional intelligence is the essential resource required for nurses. Concerning anticipated outcomes of the intervention, the number of attempts to address Working Bullying (WB) at the organizational level will decrease, while changed behavior will help nurses lower the frequency of WB. The success of the intervention should be evaluated with the help of statistical methods, calculating the number of WB cases before and after the change in nurses’ behavior.


In conclusion, it is necessary to state that these two discussed interventions target nurses’ burnouts prevention and patient safety-enhancing at the self-help level. Firstly, a blended format, including distance learning, of the participation in stress management and resiliency training was considered to help nurses cope with stress caused by overworking and long business trips. Secondly, changed personal behavior with the help of emotional intelligence was proposed to cope with workplace bullying. However, one should not forget that the problem cannot be solved without any regulations made at the organizational level.


Edmonson, C., & Zelonka, C. (2019). Our own worst enemies: The nurse bullying epidemic. Nursing administration quarterly, 43(3), 274-279.

Garcia, C. D. L., Abreu, L. C. D., Ramos, J. L. S., Castro, C. F. D. D., Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on patient safety: systematic review and meta-analysis. Medicina, 55(9), 553.

Johnson, J., Cameron*, L., Mitchinson, L., Parmar, M., Opio-te, G., Louch, G., & Grange, A. (2019). An investigation into the relationships between bullying, discrimination, burnout and patient safety in nurses and midwives: is burnout a mediator?. Journal of Research in Nursing, 24(8), 604-619.

Magtibay, D. L., Chesak, S. S., Coughlin, K., & Sood, A. (2017). Decreasing stress and burnout in nurses: efficacy of blended learning with stress management and resilience training program. JONA: The Journal of Nursing Administration, 47(7/8), 391-395.

Smith, C. R., Palazzo, S. J., Grubb, P. L., & Gillespie, G. L. (2020). Standing up against workplace bullying behavior: recommendations from newly licensed nurses. Journal of nursing education and practice, 10(7), 35.

Zhang, X. J., Song, Y., Jiang, T., Ding, N., & Shi, T. Y. (2020). Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine, 99(26), 1-13.